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Epidemic typhus is a severe infection caused by Rickettsia prowazeckii, a strictly intracellular bacteria transmitted by body-lice (Pediculus humanus humanus). It has caused several devastating epidemics in the past (with death rates of 10 to 30 percent when no treatment is given) and is now a re-emerging pathogen causing more recent epidemics – in 1997 in Burundi, for example, where 100 000 cases were reported – and several sporadic cases, particularly in populations exposed to body-lice such as the homeless and other at risk populations. The clinical picture is highly variable and requires both prompt and empiric treatment.
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